The Centers for Medicare and Medicaid Services (CMS) continues its focus on dementia care in nursing homes, particularly the overuse of antipsychotic medications. Several years ago, CMS partnered with federal and state agencies, nursing homes, other providers, advocacy groups, and caregivers to improve comprehensive dementia care. According to CMS, by 2014 nursing homes achieved a 19.4 percent reduction in antipsychotic drug use, exceeding the first year goal of a 15 percent reduction.
CMS announced in recent surveyor guidance that more needs to be done to address issues relating to the care of nursing home residents with dementia. In addition, CMS stated that the agency and the organizations participating in the partnership announced a new goal to achieve a 30 percent reduction in the use of antipsychotic drugs in nursing homes nationwide by the end of 2016. See Survey and Certification Letter: 15-31-NH.
In fiscal year 2014, CMS invited states to participate in focused pilot surveys related to dementia care. Five states participated in the pilot: California, Minnesota, New York, Illinois, and Louisiana. Each state completed one observational visit and four focused surveys. The purpose of the pilot study was to more thoroughly examine the prescription of antipsychotic medications, assess compliance with federal regulations relating to dementia care in nursing homes, and give insights about survey issues relating to dementia care in order to modify the survey process.
CMS announced that it plans to expand the dementia survey pilot project to additional states during 2015. States may volunteer to use the revised dementia survey tools. According to CMS, the 2015 expanded survey project will involve a more intensive, targeted effort to improve surveyor effectiveness in citing poor dementia care and the overutilization of antipsychotic medications than the 2014 pilot project.
Although CMS has not expanded dementia focused surveys nationwide, the new pilot project indicates the agency’s continued focus on dementia care in nursing homes. Whether or not your state takes part in the expanded pilot project, antipsychotic drug use is examined during the regular survey process. In addition, antipsychotic drug use was added in February 2015 to the algorithm used as part of each nursing home’s quality measure score in the CMS Five Star Rating System that is part of the Nursing Home Compare website. Thus, nursing homes should examine their dementia care, particularly the use of antipsychotic drugs.